Watson Thomas J
Division of Thoracic and Foregut Surgery, Department of Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box Surgery, Rochester, NY, 14642, USA,
World J Surg. 2015 Jul;39(7):1634-41. doi: 10.1007/s00268-015-3012-x.
Achalasia is a disease for which treatments are palliative in nature. Success of therapy is judged by a number of metrics, the most important being relief of symptoms, such as dysphagia and regurgitation. Patients often compensate for symptoms though a variety of dietary and lifestyle modifications, making symptomatic assessment of therapeutic outcome unreliable. Given this fact, and the progressive nature of the condition if left inadequately treated, patients not infrequently present with the disabling manifestations of end-stage disease for which esophagectomy is the best option. In appropriately selected patients, and when performed in experienced centers, esophagectomy with foregut reconstruction can be undertaken successfully with acceptable rates of morbidity and mortality, as well as a good long-term symptomatic outcome, in cases of end-stage achalasia.
贲门失弛缓症是一种本质上只能进行姑息治疗的疾病。治疗的成功与否通过多种指标来判断，其中最重要的是症状的缓解，如吞咽困难和反流。患者常常通过各种饮食和生活方式的调整来代偿症状，这使得对治疗效果进行症状评估不可靠。鉴于这一事实，以及如果治疗不充分病情会逐渐发展的特性，患者常常会出现终末期疾病的致残表现，而食管切除术是治疗这种情况的最佳选择。在适当选择的患者中，并且在经验丰富的中心进行手术时，对于终末期贲门失弛缓症患者，行食管切除并重建前肠能够成功进行，且发病率和死亡率在可接受范围内，长期症状改善效果良好。
